A patient presents with decreased ejection fraction and symptoms of heart failure. What should be done to evaluate for antibody-mediated rejection?

The correct approach to evaluate for antibody-mediated rejection in a patient with decreased ejection fraction and symptoms of heart failure is to screen for circulating donor-specific antibodies. In the context of heart transplant recipients, the presence of donor-specific antibodies can be a key indicator of antibody-mediated rejection, which can significantly affect cardiac function and patient outcomes.

Testing for these antibodies involves blood tests that measure the immune response to the donor heart, helping to identify whether the body is mounting an immune response against the transplanted organ. Elevated levels of donor-specific antibodies are associated with an increased risk of rejection, and their detection can prompt immediate evaluation and management to mitigate heart failure symptoms and improve ejection fraction.

In contrast, measuring serum creatinine levels primarily assesses renal function and is not specific for evaluating heart rejection mechanisms. Changing immunosuppressive medications may be a consideration if there are signs of rejection; however, it does not directly assess for the presence of donor-specific antibodies. Conducting imaging studies can provide valuable information about heart structure and function but does not directly address the underlying immune response that may be contributing to rejection.